People with fibromyalgia say that their muscles feel like they have been pulled or overworked, and sometimes they twitch or cramp.8 Even the skin may feel badly sunburned.9 To help your family and friends relate to your fibromyalgia symptoms, have them think back to the last time they had a bad flu. Every muscle in their body shouted out in pain. In addition, they felt devoid of energy as though someone had unplugged their power supply.

Symptoms sometimes begin after a physical trauma, surgery, infection or significant psychological stress. In other cases, symptoms gradually accumulate over time with no single triggering event.

Women are much more likely to develop fibromyalgia than are men. Many people who have fibromyalgia also have tension headaches, temporomandibular joint (TMJ) disorders, irritable bowel syndrome, anxiety and depression.

While there is no cure for fibromyalgia, a variety of medications can help control symptoms. Exercise, relaxation and stress-reduction measures also may help.

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Tender points

The pain associated with fibromyalgia often is described as a constant dull ache, typically arising from muscles. To be considered widespread, the pain must occur on both sides of your body and above and below your waist.

Fibromyalgia is characterized by additional pain when firm pressure is applied to specific areas of your body, called tender points. Tender point locations include:

¦Back of the head

¦Between shoulder blades

¦Top of shoulders

¦Front sides of neck

¦Upper chest

¦Outer elbows

¦Upper hips

¦Sides of hips

¦Inner knees

Fatigue and sleep disturbances

People with fibromyalgia often awaken tired, even though they report sleeping for long periods of time. Sleep is frequently disrupted by pain, and many patients with fibromyalgia have other sleep disorders, such as restless legs syndrome and sleep apnea, that further worsen symptoms.

Fibromyalgia generally doesn't lead to other conditions or diseases. But the pain and lack of sleep associated with fibromyalgia can interfere with your ability to function at home or on the job. The frustration of dealing with an often-misunderstood condition also can result in depression and health-related anxiety.

In 1990, the American College of Rheumatology (ACR) established two criteria for the diagnosis of fibromyalgia:

¦Widespread pain lasting at least three months

¦At least 11 positive tender points — out of a total possible of 18

But fibromyalgia symptoms can come and go. And many doctors were uncertain about how much pressure to apply during a tender point exam. While the 1990 guidelines may still be used by researchers studying fibromyalgia, less stringent guidelines have been developed for doctors to use in general practice. These newer diagnostic criteria include:

¦Widespread pain lasting at least three months

¦No other underlying condition that might be causing the pain

Blood tests

While there is no lab test to confirm a diagnosis of fibromyalgia, your doctor may want to rule out other conditions that may have similar symptoms. Blood tests may include:

¦Complete blood count

¦Erythrocyte sedimentation rate

¦Thyroid function tests

n general, treatments for fibromyalgia include both medication and self-care. The emphasis is on minimizing symptoms and improving general health.

Medications

Medications can help reduce the pain of fibromyalgia and improve sleep. Common choices include:

¦Analgesics. Acetaminophen (Tylenol, others) may ease the pain and stiffness caused by fibromyalgia. However, its effectiveness varies. Tramadol (Ultram) is a prescription pain reliever that may be taken with or without acetaminophen. Your doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs) — such as ibuprofen (Advil, Motrin, others) or naproxen sodium (Aleve, others) — in conjunction with other medications.

¦Antidepressants. Duloxetine (Cymbalta) and milnacipran (Savella) may help ease the pain and fatigue associated with fibromyalgia. Your doctor may prescribe amitriptyline or fluoxetine (Prozac) to help promote sleep.

¦Anti-seizure drugs. Medications designed to treat epilepsy are often useful in reducing certain types of pain. Gabapentin (Neurontin) is sometimes helpful in reducing fibromyalgia symptoms, while pregabalin (Lyrica) was the first drug approved by the Food and Drug Administration to treat fibromyalgia.

3 Replies

It was years before my rheumatologist mentioned that my symptoms were more fibro than inflammatory arthritis! Once I read the blurb in fibro, things clicked into place. getting a proper diagnosis is the first hurdle. Getting a handle on the pain is the second. 15 years into it, I have only been prescribed Gabapentin relatively recently and am now on 600mg three times per day, as well as other drugs. Am left wondering why it wasn't prescribed sooner grrr.

I have only recently gone onto gabapentin and not quite taking the full dose, trying to manage, this is the first time and I have had fibro now for over 10 years, several meds later I actually think this one is working at last, fingers crossed